AARFinalMedical_needs_for_disaster

AFTER ACTION REPORT FY2009 TCN 09238 Workshop Education and Training Needs for Disaster Medicine and Public Health Preparedness Building Consensus, Understanding and Capabilities May 5-6, 2010 • Hilton Washington DC North/Gaithersburg, Maryland The views, opinions, and/or findings contained in this report are those of the author(s) and should not be construed as an official Department of the Defense position, policy or decision, unless so designated by other documentation i Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities TABLE OF CONTENTS INTRODUCTION 3  PREFACE 3  HANDLING INSTRUCTIONS 3  EXECUTIVE SUMMARY 5  OVERVIEW 5  COMPARISON OF KEY FINDINGS FROM W ORKSHOP #1 TO THOSE FROM THE NCDMPH INAUGURAL MEETING 7  SUMMARY OF PARTICIPANT FEEDBACK .8  WORKSHOP OVERVIEW 9  BACKGROUND 10  WORKSHOP STRUCTURE 13  WORKSHOP EVALUATION 14  WORKSHOP RESULTS 15  OBJECTIVE 15  OBJECTIVE 15  OBJECTIVE 17  OBJECTIVE 18  RECOMMENDATIONS AND CONCLUSIONS 19  RECOMMENDATIONS FOR FUTURE W ORKSHOPS .19  CONCLUSION 20  Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities FIGURE Figure 1: BREAKOUT SESSION DESIGN TABLES Table 1: EDUCATION AND TRAINING INVOLVEMENT Table 2: SHARING OF TRAINING AND EDUCATION INFORMATION APPENDICES Appendix 1: WORKSHOP AGENDA Appendix 2: FACILITATOR BIOGRAPHIES Appendix 3: PRESENTER BIOGRAPHIES Appendix 4: ORGANIZATIONS REPRESENTED Appendix 5: PARTICIPANT SURVEY RESULTS Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities INTRODUCTION PREFACE This workshop was conducted through the Integrated Civilian-Military Domestic Disaster Medical Response program of the Yale New Haven Center for Emergency Preparedness and Disaster Response under TCN 09238 funded by the United States Northern Command This task requires conduct of a study to (1) clarify the federal disaster medicine and public health education and training products currently in existence, (2) identify needs and explore strategies to fill education and training gaps and (3) synthesize long-term expectations of competencies The means to accomplish this study is through a series of at least six (6) workshops where federal and non-federal stakeholders would convene This workshop served as the first of the six workshops It was sponsored by the National Center for Disaster Medicine and Public Health, the Federal Education and Training Interagency Group for Public Health and Medical Disaster Preparedness and Response, the United States Northern Command and the Yale New Haven Center for Emergency Preparedness and Disaster Response HANDLING INSTRUCTIONS The title of this document is FY’09 TCN 09238 Workshop #1 Education and Training Needs for Disaster Medicine and Public Health Preparedness Building Consensus, Understanding and Capabilities After Action Report For additional information, please consult the following points of contact: Beverly M Belton, RN, MSN,CNA-BC 09238 Task Lead Yale New Haven Center for Emergency Preparedness and Disaster Response Church Street, 5th Floor New Haven, CT 06510 T.203.688.4470 F.203.688.4618 beverly.belton@ynhh.org Noelle Gallant, M.A 09238 Training and Evaluation Specialist Yale New Haven Center for Emergency Preparedness and Disaster Response Church Street, 5th Floor New Haven, CT 06510 T.203.688.4137 F.203.688.4618 noelle.gallant@ynhh.org Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities Special thanks to the Workshop Planning Committee: CAPT D.W Chen, MD, MPH, Department of Defense Rick Cocrane, MPH, MA, Department of Defense Michael Handrigan, MD, FACEP, Department of Health and Human Services Debbie Hettler, OD, MPH, FAAO, Department of Veterans Affairs Wanda King, MS, Centers for Disease Control and Prevention Kenneth Schor, DO, MPH, National Center for Disaster Medicine and Public Health Merritt Schrieber, CAPT, PhD, Department of Defense Kandra Strauss-Riggs, MPH, National Center for Disaster Medicine and Public Health Andrea C Young, PhD, Centers for Disease Control and Prevention Yale New Haven Center for Emergency Preparedness and Disaster Response Workshop Planning Group & Staff: Joseph Albanese, PhD Kristy Anderson, BS, CEM, LP Susan Begien Beverly M Belton, RN, MSN, CNA-BC Rebecca Cohen, MPH Lynn M Egan Lauren Esposito Elaine Forte, BS, MT (ASCP) Noelle Gallant, MA Kristi Jenkins Edith Kaye, BS, MS LTC (Ret) Joanne McGovern Bruce Pantani, MCP+1, MCSE Mark Schneider, MBA, NREMT Eugenie V Schwartz, BSN, MHA Stewart D Smith, MPH, MA, FACCP Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities EXECUTIVE SUMMARY OVERVIEW The first of the six workshops required for completion of activities associated with TCN 09238 was designed to build on the work begun by the National Center for Disaster Medicine and Public Health (NCDMPH) at its inaugural workshop entitled, “A Nation Prepared: Education and Training Needs for Disaster Medicine and Public Health”, that was held September 24-25, 2009 The NCDMPH used their inaugural meeting to perform an initial needs assessment and bring together federal partners in a dynamic workshop intended to support networking across federal agencies and gathering of data that would be useful for the assessment In addition, the inaugural meeting was structured to facilitate its replication and the collection of comparative data from other relevant stakeholders The target audience for our first workshop included federal and non-federal stakeholders These participants were brought together for discussion of key issues, information sharing and networking related to disaster medicine and public health education and training Participants were expected to: receive the latest update regarding key federal activities and legislation, share federal and private sector education and training integration strategies and develop recommendations and a way ahead for future collaboration The table below illustrates the alignment of the objectives of this first workshop with those from the workshop conducted by the NCDMPH Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities TCN 09238 Workshop #1 NCDMPH Inaugural Meeting Information and Communication Information Organization Needs • • To discuss and gather input from participants regarding the accessibility of information during a disaster or public health emergency To assess the needs of those of those gathering disaster medicine and public health information for decision-makers IM/IT Needs for Education and Training • To focus on the increase in distance learning and social media as tools for education and training delivery Capabilities and Competencies Competencies • • To discuss and gather input from participants regarding the use of competencies to guide education and training (with a special focus on workforce development) Workforce Learning Requirements and Needs • To discuss and gather input from participants regarding education and training requirements and needs • To discuss and gather input from participants regarding organizational education and training incentives and mandates Disconnects and Barriers • To provide and gather input from participants regarding education and training disconnects and barriers To gauge the level of acceptance by federal staff with the general move in the field towards core competencies and the tenets of the Pandemic and All Hazards Preparedness Act Incentives and Mandates • To elicit feedback on the best ways to encourage learning by the disaster medicine and public health workforce Federal and Non-Federal Education and Training Disconnects • To elicit federal sector perspectives on the separation between education and training they develop, fund and offer and what is available and accessible to the non-federal sector Learning Research Needs in Disaster Medicine and Public Health • To assess the possible gaps in the education research base and which education and training delivery methods are most successful Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities COMPARISON OF KEY FINDINGS FROM WORKSHOP #1 TO THOSE FROM THE NCDMPH INAUGURAL MEETING Multiple areas of congruence exist between feedback from the federal partners in attendance at the inaugural meeting sponsored by the NCDMPH and the attendees at this meeting The table below summarizes some of the key perceptions of the respondents NCDMPH Inaugural Meeting ICMDDMR WORKSHOP #1 General General • Need for developing core competencies recognized • Need for developing core competencies recognized • Need for standardizing training and education • 50% of respondents feel core competencies should be developed as a collaborative effort between: federal agencies, academia, professional organizations, accrediting bodies and state and local governments • 98% of respondents agree or strongly agree that there should be a greater standardization of competencies across federal and non-federal agencies Incentives and Mandates Incentives and Mandates • Incentives are the preferred way to encourage learning • Incentives and mandates are used to encourage participation and learning • Mandates are a better way to achieve a better trained, better educated disaster health workforce • Federal grants are recognized as an effective incentive for education and training by 60% of respondents • Respondents believe incentives are more effective than mandates for education and encouraging participation in training • 75% of respondents identified job requirements as the strongest motivator for their peers to become educated and/or trained • 40% of respondents identified job requirements as their personal strongest motivator to become educated and/.or trained Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities Workforce Learning Requirements and Needs Workforce Learning Requirements and Needs • • In-person training preferred, although distance learning is seen as a more costeffective alternative Federal and Non-Federal Education and Training Disconnects • Disparate funding streams were identified as barriers to successful education and training collaboration across federal department and with the non-federal sector Respondents felt drills and exercises are the most useful and effective education and training modalities with the current workforce Disconnects and Barriers • Funding was identified as a key barrier to training SUMMARY OF PARTICIPANT FEEDBACK Based on feedback from participants, all objectives of the workshop were achieved See Appendix for participant survey results Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities WORKSHOP OVERVIEW Workshop Title: Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities The Agenda is provided in Appendix Location and Date: Hilton Hotel Washington, DC North/Gaithersburg, Maryland, May 5-6, 2010 Workshop Format: The workshop took place over 1.5 days and consisted of plenary sessions, a working lunch and concurrent breakout sessions that were followed by a structured group report out and a closing plenary session that presented the perspective of a special population and asked the group to consider the way ahead as we continue to explore issues related to the education and training needs for disaster medicine and public health preparedness Participants were pre-assigned to one of the concurrent breakout sessions Special attention was given to distributing organizations and roles across the groups in order to facilitate dialogue and sharing of ideas among all stakeholders Targeted Audience - Representatives from the following groups: • • • • • State and local government Accredited academic organizations Professional organizations Private sector entities involved in competency development Practitioners in the field Objectives: This workshop sought to bring together federal and nonfederal stakeholders for discussion of key issues, information sharing and networking related to disaster medicine and public health education and training During the workshop attendees could expect to: • • • Receive the latest update regarding key federal activities and legislation Share federal and private sector education and training integration strategies Develop recommendations and a way ahead for future collaboration Participating Organizations: This workshop was sponsored by the National Center for Disaster Medicine and Public Health, the Federal Education and Training Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities Chart #39 Is the re a ne e d fo r s ta nd a rd ize d ta xo no my to he lp m a k e info rma tio n o rg a nize d a nd a c c e s s ib le ? No, 0% Don't know, 5% Yes, 42 95% Chart #40 W t is the b e s t wa y to d is s e m ina te i nfo rma tio n to p re p a re d ne s s p ro fe s s io na ls a nd re s p o nd e rs ? Cho o s e o ne a ns we r Discussion with a trusted source, 8% Media (e.g TV, radio, newspaper), 8% Social networking platforms, 0% Websites, 32 84% A5-22 Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities Chart #41 D o y o u b e lie v e it is imp o rta nt fo r y o ur a g e nc y to e ng a g e in s o c ia l me d ia (e g Fa ce b o o k, T witte r, Y o uT ub e , B lo g s , 2nd Life ) Don't know, 16% Yes, 26 61% No, 10 23% A5-23 Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities PARTICIPANT/ORGANIZATION COMPETENCY ACTIVITY INFORMATION SHARING FORM Chart #42 Competency Models Used as a Human Resources Tool by Workshop Participants 25 23 20 15 18 17 14 10 Professional/talent selection Curricula development Professional development Performance appraisal Succession planning Chart #43 Does your organization develop, conduct or offer trainings that contribute to complinace with competencies? 30 25 26 25 20 16 15 10 Develop Conduct Offer A5-24 Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities Open-ended Question #1: Please list the top three regulatory bodies that develop the competencies most affecting your organization: • • • • • • • • • • • • • • • • • • • • • • • • • • • • NAACHO, FEMA, CDC JCAHO, State Health Dept, DHHS Joint Commission, Foundation of Higher Education for Disaster/Emergency Management Joint Commission, Boards, Local Regulators DOT, OSHA, DHS American PH Association, University Schools of PA, HHS (CDC & ASPR) Joint Commission, NFPA, OSHA ANA, Clinical Specialist, ENA OSHA DHS, HHS, Agency Policy Federal, State, RRC ANA, IAFN, AACN ASPH, AMA, ANA DoD, US Navy, JCAHO NHTSA, DHS, HHS Air Force Surgeon General, OSD (Health Affairs), DoD Policy FEMA, Dept of Homeland Security, Maryland Emergency Management Agency White House, Homeland Security, HHS MIEMS, NREMTs, Montgomery County CDC, AMA, Nursing Association CHS/JC, OSHA, FEMA Congress, Executive Branch HHS, NRC, OSHA FEMA, State Public Health, Mutual Aid ASPR/DHHS, DHS ACCME, CME Joint Chiefs, Sec Def, President/WH A5-25 Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities Open-ended Question #2 - What modifications to overall competency development and expectation would most benefit your organization's ability to be compliant with regulations? • • • • • • • • • • • • • • • • • • • • Must be practical and apply to civilians Competencies don't equal regulations or requirements as long as these remain in the realm of education only; they will not be carried out in the workforce It needs to be Identification of one competency and measures to evaluate/validate would be helpful Engage private sector and general population Nothing will change until employers recognize the value of hiring those with certified competence Afford staff time away from their job to attend to the task at hand - Do the competencies required to be compliant and NOT fudge the report of compliance, that I see done on a daily basis on my job Funding and reprioritization of missions My office is very proactive with developing and assessing competency National consensus on competency set(s) Funding for EMS / EMS Physicians and Clear competencies resulting in demonstrable capability Clear, measurable competency with link to training programs Ensure we are NIMS/ICS compliant and certified Competencies that inform 1st responder about public health, preparing and becoming comfortable with change to disaster operations The standards and competencies seem to be effective in the determination of specific requirements (i.e NFPA instructing a firefighter to perform search and rescue in a particular manner); some of the more non-specific or random competencies appear to no serve a real purpose except to classify classes (sometimes square peg in a round hole) Require FEMA to be NIMS compliant Standardization of competencies across related disciplines (job and team related) Standardization of Taxonomy To know and understand needs in educating for compliance, what curricula needs built to support compliance? Competencies in workforce safety and info technology (GIS/PUCT) A5-26 Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities Open-ended question #3 - What long-term expectations does your organization have for overall competency development for your sector? • • • • • • • • • • • • • • • • • • All public health staff is ready and willing to respond to all hazards events I'm not sure my organization is even aware of the competencies; They probably won't be until there is some sort of requirement Curriculum revision based on competency validation for program value, student recruiting, integration into possible grant streams Developing effective education/training plans/exercises/courses few Competency development and assessment is a core function for my office All employees have increased awareness, knowledge and operational skills Funding for EMS - Deliverables for defined/specific capabilities - Creating a culture of preparedness for responders Develop effective / precise training programs to meet core competencies Continued growth Our organization is undergoing major re-organization so I am presently not sure I can answer this question We will be expected to be there on the front lines will we understand and be able to integrate with outside sources Our center is not necessarily a competency-setting organization but rather analyzing and consolidating the current ones, as well as using them in curriculum development Adaptation of competencies for Disaster Reserve Workforce Shared and published - collaboratively based - developed competencies that are regularly reviewed and validated by peer groups and organizations Be ready for deployment and be the 'Best' among the first responders Standardized core with tailored specialties A5-27 Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities Open Ended Question #4: What modifications to overall competency development and expectation would be most beneficial to developing your workforce and providing the best service to the community? • • • • • • • • • • • • • • • • Tied to training and/or job or organizational requirements and then failure to comply must come with penalties or other methods of enforcement Greater awareness of risk/benefit Need to focus on both urban and rural needs Include USPHS Officers in the design, conduct and delivery of this Need to move beyond competency models - (e.g we are working on developing career mapping tools) Hand-on workshop as a team with local community Clear, attainable competencies resulting in measurable capabilities able to be practiced for true stakeholders (responders) Interagency focus; Better understanding each other's capabilities and how we can integrate our effort More incentives to pursue education and training opportunities Be more State and Local focused vs top-down Having front line competencies for 1st responders Work with education developers/specialists on crafting them, not just the subject matter experts Have these less cryptic and academic, so that it is jot just the institution who understands them, but also the learners and outside agencies who may use them Adoption of competency based professional development Getting those competencies communicated to the employees and supervisors making these individuals accountable for building capacity and capabilities Funding and Incentives Standard Guidelines with Mandates Clear 26 directives from executive branch A5-28 Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities SATISFACTION SURVEYS Chart #44 – Knowledge Gained by Workshop Participation Federal activities related to disaster medicine and public health education and training 30 27 25 20 17 Knowledge Before Workshop 14 15 Knowledge After Workshop 10 5 0 Full Good Some Little Understanding Understanding Understanding Understanding Chart #45 – Knowledge Gained by Workshop Participation Legislation related to disaster medicine and public health education and training 25 22 19 20 15 13 Knowledge Before Workshop Knowledge After Workshop 10 5 0 Full Understanding Good Understanding Some Understanding Little Understanding A5-29 Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities Chart #46 – Knowledge Gained by Workshop Participation Gaps in workforce response that could be addressed through enhanced education and training 30 25 25 19 20 10 5 Knowledge Before Workshop 14 15 Knowledge After Workshop Full Good Some Little Understanding Understanding Understanding Understanding A5-30 Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities Chart #47 – Speaker Evaluation 25 23 20 16 15 15 Excellent 13 11 Good Average Below Average 10 Poor 10 6 6 1 0 0 How would you rate the speaker who conducted the May 5th morning session: Disaster Case Study Presentation? How would you rate the moderator who conducted the afternoon session on Wednesday, May 5th? How would you rate speaker who conducted the Thursday, May 6th morning session: Analysis/Vision/Strategy? How would you rate the Thursday, May 6th Plenary Speaker: Robert Kadlec? A5-31 Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities Chart #48 – Speaker Evaluation 35 31 30 26 25 23 21 Excellent 20 18 Average 16 15 15 10 Below Average 13 11 11 10 Poor 10 5 Good 0 0 How would you How would rate How would you How would you rate the location of the rate the food rate the parking accommodations this workshop accommodations provided by the (Hilton provided by the Hilton Washington provided by the Washington DC) Hilton Washington DC? Hilton Washington DC? DC? 0 How would you rate the preregistration process 0 How would you rate the on-site conference checkin process? A5-32 Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities Open-ended question #1 - What did you find most useful about the workshop? • • • • • • • • • • • • • • • • • • • • • • • • • • Federal Activities Brief; Dr Kaplowitz presentation was comprehensive; Kathleen Miner's presentation in Affective Domain of Professional Education There was a nice discussion on both sides of the topics, presented Gave a good non-biased analysis of the topic Q-A sessions Networking - More Sharing! Need to get workshops creating products - issues have been identified for years in other forums - get workshop participants into action workshops Networking Networking, Q&A Open dialog genuine commitment to engage and open lines of communication Networking, awareness, otherwise needed to be better focused, too diffuse and all over the place Usually networking Info provided Debrief from afternoon breakout sessions Review of federal resources and programs Networking with participants, idea generator networking Networking, info on PowerPoint presentations Networking and hearing perspectives from various private and public entities Discussion during break out sessions, actually everything was well presented The summary session Networking Networking and attendee list with email, would we also, would we also specialty areas of work for attendees all in one - did not have to leave facility for food, etc I did not find it very useful No new information was provided and not much input from non-federal stakeholders was solicited Bringing non-federal partners together is great; they need to be utilized more Fed updates Federal Agency briefing/updates Networking Gaining knowledge of various federal agencies role in disaster preparedness/response Networking, hearing from federal agencies and understanding better where gaps exist in training and education Networking A5-33 Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities • • • • • • Conversations at the table and during breaks Opportunity to meet other colleagues involved in education and training disaster response Discussion in afternoon session Different groups in the same room Gaining knowledge and ideas Networking opportunities Open-ended question #2 - Are there any topics that you would have liked to have been covered, but were not? Please list • • • • • • • • • • • • • • • • Community education and part of preparedness and readiness to be self sufficient in first 72 hours before the assistance arrives Information about Resilience Directorate State - Local - Tribal - Territorial needs from training to recovery Sharing info across agencies/organizations, etc Creating a one stop shop for medical/public health entities to get info on available training, lessons learned, etc Core competencies for disaster response - Not a debate over the definition of competencies, but rather - What are the basic knowledge points that all responders need to know More directly P/T to educators - may be invitation only? And more directly pts linking TCL to competency in PH preparedness and response as well as recovery Cost of doing business; Regionalization; Private sector impacts; Broader inclusion of "workforce" (e.g EMS, public safety) Focus Need to include how EMS fits in NHSS; How are these efforts linked with what HRSA can fund, etc.? I wish Dr Marcozzi's plenary session went into more detail about the White House / Executive Branch's functioning & role in disaster recovery There was a lot of overlap with the other speakers Competency or capability? When looking at workforce how to measure with some degree of comfort, ability to use knowledge apply skills to the job Prevention/Mitigation Does your disaster medicine include animals? CoMPASS presentation Less discussion on terminology - readiness vs preparedness, etc Move ON! Just Semantics Crisis standards of care; Vulnerable populations; Use of Social Media in disasters; Cultural competencies as an essential composite of core-competencies A5-34 Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities • • • • • • • • • How the federal gov't is being inserted into the overall DM plan for this country Cross training efforts for employers not normally involved in response; surge workforce development approaches; more "how to use' competencies Would suggest Microsoft that uses competencies from recruitment to post retirement Academia gaps with recommendations for change and integration with gov't and non-gov't; Change perspective of "importance of role" to all jobs are important and leave the title at home and go to best job to mitigate event.; Continue the dialogue on sharing fed and private _ and training integration How to take all of the competencies and capabilities out there and figure out which ones are really core and which ones actually yield improved disaster response Capabilities Workshop The federal agencies seem to be a bee-hive of different, but redundant, yet complicated missions I overheard a fellow participant expressing confusion and suggesting a presentation where one person charts the spaghetti out to complement the federal briefings, what is the connection? In the future, how to get funding for conducting 4-8 hour training session for health care providers and key non health care personnel through local hospitals or professional organizations Development of strategic plan to achieve the FETIG/NCDMPH's goals Panel on what non-government entities are doing at the community level; Recognition on day about how the issues of children and disaster are different for adult populations A5-35 Education and Training Needs for Disaster Medicine and Public Health Preparedness: Building Consensus, Understanding and Capabilities Open-ended question #3 - General comments regarding the workshop • • • • • • • • • • • • Some of the breakout sessions were griping sessions If were more structure to the breakout sessions than the discussions will be more cogent and productive It appears to be a number of the old dogs promoting agendas - not a lot of advancement made - I understand that its a 1st meeting but it did not appear to be focused on common goal More audience participation a lot of talent in the room that did not speak up Get people to sign up for mini sessions or future workshops to get issues off the table and into action - i.e competencies - credentialing plans/documents If there were clear goals for the break out sessions, they were never passed on; It was not clear what the goals of this were; Dr Kaplowitz's presentation should have been done on Day to me, it set out what should have been the goals of this conference; The breakout sessions should be run by Experienced Emergency Managers with clear mission objectives Overall average, fell below expectations; Speakers were good in presentation (without lunch day 1): presentation overworked and information mostly interesting, but much of the time NOT useful for educators/planners engaged in curriculum planning.; Were the speakers the best fit for the conference title?; Good format mix: panel speaker breakouts, pace was ideal; Confusing: Medical model wave throughout the conference yet foundation reference was to PAHPAs public health workforce; Breakout session (among conversations with attendees) - not clear (useful) how the sessions related to conference title - and surveys didn't allow variety in opinions; Discussion of CoMPASS, TRAILS, etc Open-source - Misplaced If important should have been raised in different venue other than Q&A; Fed models, workshops and planning may not be well known/understood by state-locals While it is great to catalog training (need the good housekeeping stamp of approval, anyone can self-proclaim expertise) - its not particularly helpful if it isn't good or if it doesn't support improving competencies.; There should be core competencies across categories - (everyone needs to know ICS) and category specific competencies - Nurses need to know Excellent Job; Great Start; Sincere and Open Dialogue Focus more too much unrelated material and discussion - not relevant to training and education Workshop good, Great Location (5 minutes from home) Lots of focus or statements (Fed Gov't should XYZ" I'm interested in what others can lead/do/organize Is it really a federal gov't role in each of these suggestions? Is Fed Gov't the only option? Does it make sense? Particularly if some groups want to provide input its okay for them to take on roles What about private sector, NGOs, credentialing, accreditation, academia, etc or a partnership of above to lead? Then the USG can be a Participant Not clear what "T&E" we are talking about or who audience is A5-36